Going to Hospital

Going to hospital is more than just checking in, having the procedure, and going home.

The hospital you choose, amount of excess you pay, the level of your cover and whether your treatment is spread over separate admissions are just some of the things that can affect how much you pay for your hospital visit.

You should always check with NIB before you go to hospital, to avoid any nasty surprises. It's also best to find out if you can claim workers' compensation or from a third party before you claim under your cover, as NIB will be unable to pay your benefit.

If you choose a public hospital or an NIB agreement private hospital for a procedure on your cover, you shouldn't have to pay out of pocket expenses for the following hospital-related services:

• Accommodation (room/bed) costs in a private or public hospital
• Meals for patients
• Use of theatre for your procedure
• Labour ward if you're having a baby (depending on your cover)
• Nurses
• Intensive care (depending on your cover)
• Surgically implanted prostheses which are Government approved and are on the no 'gap' list (ask your doctor or hospital for more information)

Note: Some NIB covers only cover you for the above if you're admitted as a patient in a shared ward at a public hospital.

Please be aware that in some cases you'll have to pay for paramedical services and other items like physio, drugs and disposable items.

In a private hospital, you won't be covered for things like

• private room accommodation for same day procedures
• luxury rooms
• TV hire, phone calls, newspapers, magazines
• beauty salon services
• massage and aromatherapy services
• respite care
• take home items like crutches and drugs
• experimental treatments (services not yet recognised by Medicare for benefits purposes)
• procedures normally performed in a doctor's surgery ('Type C' procedures)
• private hospital emergency fees
• donated blood, blood products, blood collection and storage
• special nursing e.g. private nurse
• out-patient services

These are examples only. By not covering things like those listed above, we help to keep your health cover contributions down.

Important Information

High Cost Drugs are sometimes used in oncology and other treatments. You may be left with large out of pocket expenses as some of these drugs are not covered by Pharmaceutical Benefits Scheme (PBS) and may not be part of the standard treatment.

You may be able to claim part of the cost of these drugs

• Inside a hospital if the drug is included in the NIB agreement with the hospital and is covered by the PBS for specific treatment for that circumstance.
• Out of hospital if your Extras cover includes the pharmaceutical prescriptions benefit.

What other costs are there?

Like all other big purchases, you should always get a quote. You'd be amazed at how quickly a simple procedure can rack up the bills.

Get your doctor or hospital to itemise the costs and explain your treatment thoroughly beforehand so you know what's covered, and what out of pocket expenses you might have. Your doctor must get your full agreement on your treatment and its costs before you go to hospital (where possible). This is called 'informed financial consent'.